Treatment of persistent pain from torture: review and commentary

Abstract

Torture and the conditions under which it is inflicted often leave persistent painful disorders. Because there may be no lasting signs, persistent pain is often misconceived as a somatic representation of psychological distress, also common after torture. This serious failure to understand the nature of persistent pain means that pain is largely overlooked and untreated in torture survivors. We carried out a systematic review on treatments for pain from torture, but found few studies and little use of current understanding and evidence. We discuss this in the context of treating pain associated with psychological distress and of the broader problems faced by the refugee and torture survivor that may take priority over pain. We propose clinical and research implications for this neglected field.

Keywords:

• Chronic pain
• PTSD
• pain assessment
• rehabilitation
• human rights

Acknowledgements

We are grateful to Emma Baird and Leslie Hearn for collaborative work on the Cochrane review of treatment for pain from torture.